When does a metacarpal fracture need surgery?

Indications for surgery of metacarpal shaft fractures include greater than 10° of angulation in the index or middle finger metacarpal, or greater than 30°–40° of angulation in the ring or small finger. In addition, open and multiple metacarpal fractures are often best treated surgically.

How long does it take to recover from metacarpal surgery?

How is it treated, and how long does it take to heal? Metacarpal fractures usually take about six to eight weeks to heal. You’ll probably have to wear a splint as part of your treatment. It covers part of your fingers and both sides of your hand and wrist, and you’ll most likely wear it for around three weeks.

Do metacarpal fractures require surgery?

A metacarpal fracture may require surgery. If your surgeon makes the assessment that the fracture will NOT give you good hand function without surgery, surgical treatment will be recommended.

What is a metacarpal shaft?

The metacarpals are long, thin bones that are located between the carpal bones in the wrist and the phalanges in the digits. Each is comprised of a base, shaft, and head.

Is it possible to repair a displaced metacarpal fracture?

Displaced fractures are likely to heal with shortening, or angulation, or rotation. These three problems can lead to functional problems with your hand, because your finger will not function in the same way once the fracture heals. Surgery to fix the fracture can be done in a variety of ways.

How is displacement of the metacarpal head treated?

Displacement usually occurs as a flexion deformity that can be reduced by exerting pressure on the metacarpal head from the palmar aspect, either directly, or using the proximal phalanx as a piston. Especially in spiral oblique fractures, shortening of the metacarpal is associated with rotational malalignment.

What causes shortening of the metacarpal in spiral oblique fractures?

Especially in spiral oblique fractures, shortening of the metacarpal is associated with rotational malalignment. Reduction, therefore, is achieved by a combination of longitudinal traction on the finger and derotation.

Can a second metacarpal be included in a splint?

In fractures of the second metacarpal, it may be sufficient to include only the second and third rays. In fractures of the fifth metacarpal, the fifth and fourth rays are included. The splint is held in place with an elastic bandage.